The Premium Iol Era: Quantifying Patient Outcomes With Mhealth Apps, Simulators, And Ai

In the era of premium intraocular lenses (IOLs), optimizing visual outcomes and patient satisfaction is a priority. Digital technology, combined with reading charts, plays a crucial role in analyzing results. Quantifying visual performance and outcomes forms the foundation for the rapid advancement of AI in ophthalmology.

Eye Clinic – Brescia, Italy. Patients who underwent cataract surgery over the past two years, with preoperative and postoperative follow-up conducted in the same location and under consistent conditions.

A single-center, retrospective cohort study was conducted on 110 patients who underwent uneventful cataract surgery with implantation of monofocal, EDOF, or trifocal IOLs. Primary outcome measurements included visual acuity at far, intermediate, and near distances using ETDRS charts and mHealth digital visual acuity apps. Reading speed and contrast sensitivity were also assessed. Near activity visual questionnaires (NAVQ) were used to evaluate patient satisfaction, compared with an app-based visual performance simulation system for near and intermediate vision. Dysphotopsia was measured using Subjective Quality of Vision questionnaire (QoV) and the same app-based dysphotopsia simulation system. A defocus curve was also generated.

Significant improvements in uncorrected distance visual acuity and patient satisfaction were observed across all IOL types. Spectacle-free intermediate vision improved with premium IOL technologies, as did near vision at reading distances of 30–40 cm. The scoring system was faster, easier, and more interactive, enhancing the evaluation of near/intermediate vision and dysphotopsia. Digital defocus curve generation provided an immediate understanding of IOL performance for individual eyes and binocular vision.

Premium IOL technology enhances visual acuity and quality of vision. As digital screen usage increases, the role of both traditional and digital visual acuity measurements becomes even more crucial. Beyond standard visual acuity, objective assessment of satisfaction outcomes—such as reduced dysphotopsia and greater spectacle independence—is essential for evaluating preoperative, postoperative, and long-term visual quality. Scoring IOL performance is not only valuable for ophthalmologists in selecting the best options for patients but also serves as a fundamental data source for AI learning, IOL classification, and further advancements in vision quality.